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Sinusitis

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That constant battle with a stuffy nose, throbbing headache, and facial pain resulting from a sinus infection is exhausting! Sinus infections, or sinusitis, can turn even the brightest day into a foggy nightmare. But fear not! In this article, we will delve into sinus infections and uncover the warning signs and symptoms that should raise your alarm bells.

What is a Sinus Infection?

A sinus infection occurs when the sinuses, the air-filled cavities in the skull, become inflamed and infected. Multiple factors, including allergies, viral or bacterial infections, and structural abnormalities in the nasal passages, can cause this infection. The symptoms may include facial pain and pressure, nasal congestion, thick nasal discharge, headache, fatigue, and cough.

When Should You Seek Medical Help for Sinus Infection? 

While mild sinus infections can often be managed at home with over-the-counter remedies, there are certain situations where it is vital to consult a doctor. If symptoms persist for multiple days, worsen after initial improvement, or are accompanied by high fever, severe headache, neck stiffness, or vision changes, it is crucial to seek medical attention as soon as possible. A doctor’s evaluation can help determine the severity, type, and appropriate treatment for the sinus infection.

Warning Signs and Symptoms of Complications  

In some cases, a severe sinus infection might lead to complications that require immediate medical attention. These complications may include spreading the infection to nearby structures, such as the eyes or brain. Warning signs and symptoms of complications include severe headache, worsening facial pain, swelling around the eyes, double vision, confusion, and high fever.

What to Expect During a Doctor’s Visit 

During a doctor’s visit for a sinus infection, the healthcare provider will typically start by conducting a physical examination. This examination may involve checking for tenderness over the sinuses and examining the nasal passages. In some cases, additional diagnostic tests and procedures, such as imaging studies or nasal endoscopy, may be recommended to confirm the diagnosis and identify the underlying cause of the infection. After confirming the diagnosis, the doctor will discuss the appropriate treatment options.

Coping with Sinus Infection 

In addition to medical treatment, multiple self-care and preventative measures can help manage sinus infections and reduce the risk of future episodes. To manage symptoms at home, individuals can use saline nasal rinses or sprays to keep the nasal passages moist, apply warm compresses to the face to relieve pain and pressure, and stay hydrated. Strategies for preventing future sinus infections include avoiding known allergens, practising good hand hygiene, and quitting smoking.
While self-care measures can be effective in many cases, knowing when to seek medical attention is crucial. If symptoms persist or recur despite home remedies, it is advisable to consult a doctor. Ongoing symptoms may indicate the need for further evaluation or a change in treatment approach. Recurrent sinus infections may require a more thorough investigation to identify underlying factors contributing to the repeated infections.

Conclusion  

Sinus infections can significantly impact one’s quality of life, but recognising the warning signs and symptoms can help prompt timely medical attention. Seeking a doctor’s evaluation is crucial when symptoms persist, worsen, or are accompanied by signs of complications. By understanding when to see a doctor and how to manage sinus infections, individuals can effectively address the condition and minimise its impact on their well-being. Remember, early intervention and appropriate treatment can lead to a faster recovery and a healthier future.

FAQs

Q: What are the symptoms of a sinus infection?
A:
Common symptoms of a sinus infection include facial pain and pressure, nasal congestion, thick nasal discharge (often yellow or green), headache, fatigue, and cough. Some people may also experience a reduced sense of smell or taste.

Q: How long should I wait before seeing a doctor for a sinus infection?
A:
If your symptoms persist for more than 10 days, worsen after initial improvement, or are accompanied by high fever, severe headache, neck stiffness, or changes in vision, it is recommended to see a doctor promptly. These signs may indicate a more severe infection or potential complications.

Q: How can I manage a sinus infection at home?
A:
While medical treatment is often necessary for sinus infections, there are some self-care measures you can try at home to alleviate symptoms. These include using saline nasal rinses or sprays to keep the nasal passages moist, applying warm compresses to the face to relieve pain and pressure, staying hydrated, and getting plenty of rest.

References:
https://acaai.org/allergies/allergic-conditions/sinus-infection/
https://my.clevelandclinic.org/health/diseases/17701-sinusitis
https://www.healthline.com/health/cold-flu/sinus-infection-symptoms
https://www.mayoclinic.org/diseases-conditions/chronic-sinusitis/symptoms-causes/syc-20351661

Sinusitis – Symptoms, Causes, and Treatment

Sinusitis is an inflammation of the sinuses affecting the nose and occasionally the face, throat, and ears. Sinuses are hollow spaces in the skull behind the forehead, eyes, cheeks, and nasal passages. These sinuses get blocked and filled with fluid due to cold or allergies, resulting in inflammation. Sinuses are cavities in the skull, while sinusitis is a condition of inflamed sinuses.

How important are sinuses?

Sinuses play a key role in protecting the body against illness and taking care of our wellness. Sinuses, the hollow spaces filled with air, lighten the head’s overall weight. They also warm and humidify the air we inhale. Sinuses help enhance one’s voice quality and speech resonance. In an accident, the sinuses absorb the impact and protect the other facial structures. Sinuses also help drain nasal mucus that protects the nasal passage and keeps unwanted particles like dust and pollutants from entering the body. Healthy sinuses are empty except with a thin layer of mucus which continuously drains the germs, dust, and dirt out, keeping the nose clean and free from bacteria, as already mentioned above.

The four pairs of sinuses are-

Maxillary sinuses: Maxillary are the largest sinuses. They are positioned behind the cheekbones near the upper jaws.

Frontal sinuses: The frontal sinuses are divided into left and right frontal sinuses. The two sinuses are located at the centre of the forehead above each eye.

Sphenoid sinuses: Sphenoid sinuses are situated behind the eyes, near your optic nerve and pituitary gland.

Ethmoid sinuses: The Ethmoid sinuses are a collection of six to twelve small air pockets between the eyes and nasal bridge. 

One develops sinusitis when the tissue lining the sinuses get inflamed or swollen. Sinusitis can also be caused by viral, fungal, and bacterial infections. 

Symptoms of sinusitis

Sinusitis and common cold have similar symptoms, some of which may include the following-

Partial or total loss of smell called Anosmia

Fever, also known as Hyperthermia or pyrexia

Nasal congestion, which causes a stuffy or runny nose

Headache due to sinus

Cough or sore throat

Fatigue

As mentioned above, many sinusitis symptoms are similar to the common cold. But the main difference is that the symptoms of sinusitis tend to be more severe, last longer, and often include pain in the face and forehead. Sinusitis symptoms range from nasal congestion and facial pain to severe headaches and tooth pain.

Types of sinusitis

Depending on the severity and duration of the symptoms, sinusitis is grouped as –

Acute – Acute sinusitis, also known as Rhinosinusitis, where rhino means ‘the nose’ is the most common one with the shortest duration. The symptoms could remain for four weeks or less. Viral infections due to cold and seasonal allergies can cause symptoms that last up to ten days.

Subacute – In the case of Subacute sinusitis, the symptoms may last up to 12 weeks. Seasonal allergies or bacterial infections cause this type of sinusitis.

Recurrent acute – As the name suggests, there would be a reoccurrence of acute sinusitis at least four times in a year.

Chronic- Chronic sinusitis is when the symptoms last for at least 12 weeks.

Possible Contributors of Sinusitis

Anyone can develop sinusitis. Excessive mucus may get formed due to cold, bacteria, or allegories that gradually allow the bacteria and germs to grow in the sinuses, leading to infection. However, apart from cold, allergies, and viral or bacterial infection, other possible factors that may contribute to the development of sinus infection are-

  • Weakened immune system
  • Dental infection
  • Smoking and Tobacco
  • Structural issues with the nose like, nasal bone growth, uneven wall of tissue between the two nostrils (nasal septum)
  • Nasal polyps
  • Cystic fibrosis, a condition where thick and sticky mucus gets buildup in the lungs, intestine, and liver, which causes damage to the respiratory and digestive systems.
  • Exposure to mold, pollen, dirt, etc.

Treatment of Sinusitis

Sinusitis is curable and treatable in most cases without consulting a doctor and antibiotics. But if the symptoms of sinusitis persist for a long, it is advisable to see your doctor and follow his advice and medications. The doctor would diagnose sinus infection based on the symptoms and the physical exam. In case of chronic sinusitis, the doctor may recommend imaging tests like X-ray, CT scan or MRI. Blood tests, nasal endoscopy, and allergy tests are a few other tests that may be needed to diagnose the severity of the infection.

In many cases, home remedies or over-the-counter (OTC) pain relieving medicines would help treat headaches or pressure in the forehead or cheeks. The doctor will prescribe antibiotic therapy to block any sinuses’ growth in cases of bacterial infection. In cases of chronic symptoms that do not improve or heal with medication, sinus surgery would be an option to clear sinuses, treat structural deformity related to the nose or remove polyps. The types of sinus surgery are-

  • Functional Endoscopic Sinus Surgery (FESS)– In FESS, with the help of a magnifying endoscope, the surgeon views and removes the infected tissue or bone. With a small incision inside the nose, an endoscope equipped with a camera and light is inserted to help reduce the blockage and drainage of sinuses.
  • Turbinate Reduction Surgery – This surgery uses radio frequency to reduce the swelling of the turbinates (tiny structures in the nose that cleanse the air passing through the nostrils). A needle-like instrument is inserted into the swollen tissue to control the damage. The turbinates gradually heal and reduce in size allowing proper and easy breathing.

Sinus Ostial Dilation Surgery– In this type of surgery, with the help of a balloon catheter inserted into the blocked sinus passage, the balloon is inflated and a saline solution is injected to flush out the mucus.

Health-promoting lifestyle is one of the ways to prevent inflammation. This includes a healthy and nutritious diet, exercise, limiting exposure to allergens and irritants, maintaining good hygiene, and avoiding contact with infected people.

Knowing the causes and symptoms of sinusitis help in treating the inflammation timely and preventing the recurrence of the same in the future.

Headaches are the most common health problem yet they can be complicated than most people realize. Each headache has its own set of symptoms which can happen for unique reasons and also needs to be treated differently. There are over 150 types of headaches. But let’s focus on rhinogenic headaches. It is a major health issue that is frequently encountered in clinical practice. Diagnosing a rhinogenic explanation for headache or facial pain outside of the classic definitions of chronic, acute, and subacute sinusitis is often challenging for the practicing otolaryngologist. Contact-point headaches are clinically characterized as causing facial pain secondary to abutting mucosal contact from the lateral nasal wall to the septum. Otolaryngologists see an outsized number of patients with rhinogenic headaches. The majority of patients with this condition are males aged 10-30 years.

So, what is Rhinogenic Headache?

Rhinogenic headache may be a pain within the head and face due to the intranasal contact point. These headaches have their primary pathophysiology centered in the nose with a headache or facial pain as a result of complex neurohumoral reflexes. Acute rhinosinusitis is that associated with the most common rhinogenic headache. Most cases are caused by viral infections (up to 98%), and only 2% are complicated by bacterial sinusitis. However primary care physicians often treat sinusitis as an acute bacterial infection by prescribing antibiotic therapy and hence contributing to the onset of resistance. Rhinogenic headache is often misdiagnosed as other conditions such as migraine.

Rhinogenic pain is usually unilateral, severe, located on an equivalent side and associated with rhinogenic symptoms, and nearly always amid endoscopic and CT abnormalities. Incidental CT mucosal diseases are often noted in 30% of asymptomatic patients.

The symptoms to look out for to know if you have Rhinogenic headache.

The symptoms of Rhinogenic headache can look like any other health-related issue. Symptoms may be different for each person. They might include:

  • Facial pain or pressure that gets worse while leaning forward
  • Nasal congestion
  • Postnasal drip
  • Toothache in the upper jaw
  • Fever
  • Cough
  • Yellowish or greenish discharge from the nose
  • Pain in the upper jaw
  • Headache
  • Deceased smell
  • Ear pressure or fullness

If you notice any combination of the above symptoms visit your ENT doctor for appropriate treatment.

Diagnosis and treatment

Rhinogenic headache can often be misdiagnosed which can then lead to improper treatment thus a detailed diagnosis is needed to identify. Once the practitioner has examined you thoroughly the treatment for the same would begin. It can be treated medically as well as surgically, both treatments have significant reduction although surgical treatment has better results.

A thorough history which incorporates elicitation of nasal congestion, symptom, facial pain, pressure, dental pain, anosmia, fever, cough, fatigue, ear fullness or pressure, precipitating factors causing the headache (head movement, stress, or cold weather after which a complete nasal endoscopy and CT scan of nose and sinuses are mandatory to make a diagnosis. Whether or not any consultation to a neurologist, allergist, or TMJ specialist has been performed, and whether or not therapy by these specialists has failed to overcome their headache. Following the history, a thorough ENT is examination is necessary with palpation of the sinuses to elicit tenderness.

Once the diagnosis has been made an aggressive medical therapy is indicated. A referral to a neurologist or TMJ specialist is encouraged as well. This is when there is no evidence or history of sinus disease on an exam or CT scan and especially there are no anatomical abnormalities. The medical therapy includes steam, hot and cold compresses, antibiotics if the sinuses have been noted, saline irrigation, analgesics, treatment of the allergy problem with steroid nasal spray, antihistamines, and leukotriene inhibitors, and time.

If the medical therapy fails then a lengthy discussion must ensue before any surgical intervention. An evaluation by a neurologist and TMJ specialist must be included for a failed medical therapy. Before the surgery full discussion of risks, benefits and alternatives is needed.

Surgery can then be performed to correct any or all of the anatomical variants that are felt to be the cause of the headache. If there is indeed a septal spur, then septoplasty should be performed in whatever manner one prefers, be it endoscopic removal of the spur, submucosal resection, or the traditional Cottle approach. Concerning endoscopic sinus surgery, this too is extremely controversial, in particular, if on a CAT scan there is no evidence of sinus disease. A repeat CT is sometimes necessary since one CT is only a snapshot in time. If indeed there is evidence of sinus disease on CT, then the indications are more definite and one needs to address the sinuses that are involved. If there is no evidence of sinus disease, then one should not operate on the sinuses unless there has been evidence of rhinosinusitis on history and exam.

So if you are experiencing the symptoms don’t ignore them and visit the doctor. The sooner you treat it the better. With proper diagnosis and treatment, it will be gone for good.

Headaches are one of the most prevalent health conditions faced by humans. There are many different types of headaches, with sinus headaches and migraines being the most common ones. The two are often misdiagnosed as both migraine and sinus headaches have similar symptoms such as runny nose and tenderness in the cheeks and forehead. This makes it hard to differentiate between the two. To understand the differences between the two, let us get an overview of sinus headaches and migraines, along with their characteristics.

Sinus Headache

Sinus headaches are characterized by the deep and constant pain in your sinuses and surrounding areas – eyes, cheeks, nose, and forehead. The pain comes with a throbbing sensation, and this is caused when there is an inflammation in the sinuses and the nasal passages. Other indicators, such as runny nose, fever, ear block, and a swollen face, also accompany the sinus headaches. Sinus headache is usually a symptom of sinusitis (sinus infection).

In sinusitis, the sinuses become inflamed, blocking the nasal passages. Healthy sinuses are filled with air, and the fluid buildup within the sinuses causes swelling in the nasal cavity. This can be caused due to viral/bacterial infections or seasonal allergies that last for an extended period.

Symptoms of Sinus Headache

  • Pain/pressure in the forehead and cheeks
  • Increasing pain on bending forward or lying down
  • Runny/stuffy nose
  • Tiredness
  • Fever

Risk Factors of Sinus Headache

  • Seasonal allergies
  • Common cold
  • Ear infection
  • Nasal polyps
  • Deviated Nasal Septum
  • Weak immune system
  • Previous history of sinus headaches
  • Family history of migraines/sinus headaches

Migraine

Migraine causes severe, throbbing pain on one side of the head. The pain is more like a pulsing sensation in the head, often accompanied by nausea, photosensitivity, and sensitivity to sound. A migraine attack can last from a few hours to several days, depending on the severity of it, and it may also interfere with one’s daily activities.

A warning symptom, commonly known as an aura occurs before or during the headache. This can include flashes of light, blind spots, a tingling sensation on one side of the face or limb, and speech difficulty.

Symptoms of Migraine

There are four stages of a migraine attack – prodrome, aura, attack, and post-drome. However, not everyone goes to all four stages. The most common symptoms during each stage are:

  • Prodrome
  • Constipation
  • Mood swings
  • Food cravings
  • Stiffness in the neck
  • Frequent yawning
  • Aura
  • Blind spots
  • Loss of vision
  • Stinging sensation in the limbs
  • The feeling of numbness on one side of the body
  • Speech difficulty
  • Attack
  • Immense pain on one side of the head
  • Throbbing ache
  • Photosensitivity
  • Sensitivity to sound
  • Nausea
  • Post-drome
  • Fatigue
  • Lightheadedness
  • Sudden pain while moving the head

Migraine Risk Factors

  • Family history of migraines
  • Age (Migraine often occurs first during adolescence and peaks during the 30s)
  • Hormonal changes
  • Skipping meals
  • Smoking
  • Depression or anxiety
  • Alcohol abuse

How can you differentiate between a Sinus Headache and a Migraine?

According to research, many people diagnosed with sinus headaches are usually experiencing a migraine attack. While telling the two conditions apart, the most important factors to consider are the symptoms and the timing, based on which the right treatment is given.

While some of the common symptoms of both sinus headaches and migraines include a running nose, watery eyes, and tenderness/pressure on the forehead, various other symptoms set them apart.

In case of a sinus headache, the mucus discharge will be yellowish, while the drainage will be clear in case of a migraine. Sinus headaches are often accompanied by fever and bad breath, while a migraine may cause nausea, dizziness, fatigue, and sensitivity to light. Women are much more prone to migraine attacks as compared to men.

Apart from the symptoms, it is important to note the timing of the headache. If the headache occurs after infections such as the common cold or flu, or after allergic reactions, it is most likely to be a sinus headache. However, if the headache occurs after consuming certain foods/alcohol, highly stressful situations, skipping a meal, insomnia, or other lifestyle-related factors, it is a migraine attack.

To diagnose a sinus headache or migraine, your doctor will ask you specific questions related to your headaches such as the frequency at which they occur, the symptoms you experience, the timing/triggers, and the family history. The doctor may also suggest physical examination, blood tests, or imaging tests for accurate diagnosis.

Treatment for sinus headache/sinusitis includes self-care measures such as steam inhalation, usage of nasal wash, nasal irrigation, and over-the-counter (OTC) medications. If the condition is severe, the doctor might prescribe corticosteroids, antibiotics, or surgery.

The treatment for migraine attacks is divided into two – acute treatment and preventive treatment. The acute treatment aims at easing the symptoms to provide relief such as moving to a cool and darkroom, cold compress, fluid consumption, OTC pain relievers, and anti-nausea medications. Preventive treatment includes various lifestyle changes such as a regular exercise regime, stress management, regular sleep schedule, avoiding exposure to triggers, and more.

Be it sinus headache or migraine attacks, the most important step towards nipping it in the bud is to be aware of the symptoms and approach your healthcare provider for the right diagnosis. Though treatment methods are available to relieve the symptoms, one can be mindful of the risk factors and avoid exposure to triggers, for prevention is better than cure!

Chronic sinusitis is an illness that causes inflammation of the lining of the nose and the sinuses. Symptoms of chronic sinusitis include facial pressure, nasal congestion, discolored nasal discharge, and post-nasal drip. The majority of the patients with chronic sinusitis can be treated with medication. However, for a small percentage of patients, infections recur and may persist for a longer course even after medication. Such patients benefit from surgery. After reviewing your medical history and x-ray studies, your ENT specialist can determine if surgery is needed.

What is balloon Sinuplasty?

Balloon sinuplasty is also known as balloon catheter dilation surgery or “smart sinus” procedure. It is a relatively new surgery and is a procedure to clear blocked sinuses. It has been approved by the Food and Drug Administration in 2005.

Balloon Sinuplasty was adapted from angioplasty, a procedure in which balloon catheters are used to dilate congested blood vessels near the heart.

The complications of the procedure are reportedly minimal and the recovery period is quite short. While the procedure is minimally invasive, it is still a surgery and it carries the kind of risks of a few side effects.

How does Balloon Sinuplasty work?

Most people who need the surgery have a condition that results in the sinus membranes becoming inflamed, preventing drainage of mucus, pus, and discharge, and causing congestion. Over time, blockage and inflammation in the nasal passages can cause symptoms, such as a headache, jaw ache, and even insomnia.

Balloon sinuplasty allows the openings of some or all three of the major nasal sinuses to be dilated. The doctors widen the blocked nasal passages by flushing out or remove congestion, often by using a saline solution.

This helps them to be cleared and drained. Balloon sinuplasty uses small balloon catheters that inflate to drain the large nasal sinuses and is typically used to treat cases of severe rhinosinusitis or sinus inflammation and blockage in the nose.

What does the balloon sinuplasty procedure include?

Depending on individual factors and preferences, balloon sinuplasty is done by an ear, nose, and throat (ENT) doctor in their office, clinic, or a hospital.

After administering a local or general anesthesia, a doctor inserts an endoscope, a thin, flexible plastic tube with a camera and light on the end, into the nasal passages. On reaching the entrance to the cavity, a small balloon catheter is advanced over the guiding endoscope wire.

The balloon is then slowly inflated and pressed against the sinus walls, once it is positioned inside the nasal passage and cavity. This is done to fracture the bone slightly and force an opening. Once the balloon is fully inflated, the cavities and passageways are flushed out using a saline rinse, and debris is further removed. Once the balloon is removed the sinus is allowed to continue to drain naturally.

Most people who undergo balloon sinuplasty have reported feelings of numbness or sinus pressure only during the surgery. Any noticeable pain is not reported.

Advantages of Balloon Sinuplasty over traditional methods

Endoscopic sinus surgery is a procedure to open the natural drainage pathways of the sinuses to restore their independent function. Endoscopic surgery comes with its risks and complications such as bleeding, recurrence of disease, spinal fluid leak, visual issues, etc.

Benefits of balloon sinuplasty over traditional endoscopic sinus surgery

  • There is a lower risk of bleeding
  • Faster recovery
  • Since there isn’t any removal of sinus tissues, structures, bones, or sinus cartilage, there is no intended damage
  • Fewer required post-operative sessions
  • Fewer medications required during and post-operation
  • reduced risk of scarring and continued inflammation

What happens after the surgery?

Usually, sinuplasty tends to have minimal side effects. However, most people can go home a few hours after the surgery is complete and return to normal activities in a day or two.

Some common side effects of Balloon Sinuplasty

  • Bloody drainage for a few days
  • Nasal, cheek, or forehead tenderness
  • Minor swelling in the nasal cavities and passages
  • Minor swelling in the surrounding facial area
  • congestion
  • Failure to properly cleanse the sinuses after the surgery can sometimes cause infection

Regardless of these minor side effects, Balloon sinuplasty is considered a very safe and effective procedure. After it was first introduced in the mid-2000s, balloon sinuplasty has become one of the most commonly performed types of sinus surgeries. It gains its popularity by being associated with high rates of success and low risks or complications.

A study conducted in 2016 found that all 15 adults who received balloon sinuplasty reported improved symptoms 3-6 months post-surgery, without any unanticipated complications or side effects. Similarly, a study done in 2017 found that balloon sinuplasty was successful in treating 94 percent of chronic sinusitis in 30 children who underwent the surgery. The positive effects persisted even a year post-surgery.